Veterans returning home: PTSD, battles rage for many

Veteran Sharon Einbinder at her Rockaway Twp home. Einbinder is a former Marine who served in Iraq and sustained a traumatic brain injury and suffers from the effects of post-traumatic stress disorder. March 18, 2014, Rockaway Twp, NJ. Bob Karp/staff photographer(Photo: Bob Karp, Staff photo)

After arriving at Norfolk, Virginia, with her unit, HMM-774, a medium helicopter squadron, she drove seven hours overnight to her apartment in Rockaway Township. "I swear to God, I kissed my stairwell," said Einbinder, now 49. "A day later, I went to Walmart in Ledgewood to get shampoo and other items. I walked into the store and felt like it was closing in on me. All of a sudden, I felt really nervous and my fingers tingled. I grabbed some shampoo and thought, I've gotta get out of here."

A woman behind Einbinder in the checkout line admired her Harley-Davidson jacket and asked to see the tailoring on the front. Einbinder snapped at her.

"I'm like, 'Well, do you see? Do you see?'" the Marine recalled. "I'm not like that at all. The woman apologized. I quickly paid for my shampoo and ran out of the store. I sat in my truck for 15 minutes, just shaking and wondering what was wrong with me. I even felt weird around my parents. I didn't want to see any of my friends."

For Einbinder, the post-traumatic stress disorder, or PTSD, diagnosis came quickly at a Veterans Affairs satellite office in the hospital where she worked as an audiologist. During her tour of duty, she said, she'd never slept more than three hours a night.

Eight years after Einbinder returned home, she is on disability and still receives professional treatment in her private battle with PTSD and the panic attacks, social phobias, hallucinations, sleepwalking — and even sleep-driving — that come with it.

PTSD is only one of many formidable and ongoing challenges veterans face when they return home from the decade-long wars. Others include dealing with respiratory illnesses from military burn pits, retraining for civilian jobs, dealing with negative civilian attitudes and, for female veterans, living with the after-effects of having served in what was for them historically dangerous situations.

The wars in Iraq and Afghanistan, the longest sustained American military operations since the Vietnam War, have sent 2.6 million men and women into service. A total of 6,819 were killed and 52,037 injured, according to the Department of Defense.

"The public has no idea what goes on over there, what it's like to be on the scene or what veterans go through when they come home," said Charles Jurgensen, an ex-Marine and veterans service officer for the Morris County Veterans Office in Morris Plains.

Forty-four percent of veterans from Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) and Operation New Dawn (OND), both in Iraq, report problems with returning to civilian life, according to the Institute of Medicine report.

"We know that the more trauma people are exposed to, the more likely they are to come out with PTSD and the more debilitating it can be," said Emily Feiner, OEF/OIF/OND program manager for the VA New Jersey Health Care System. "This is an all-volunteer service and they have multiple deployments, which is in contrast to previous conflicts. When you're talking about multiple deployments, you're talking about more opportunities to be exposed to combat trauma."

Burn pits

Starting in 2003, defense contractors used burn pits — open-air areas in the vicinity of U.S. military bases in Iraq and Afghanistan where all types of waste, from feces and tires to batteries and used medical supplies — were incinerated. Jet fuel kept the pits burning around the clock, exposing soldiers to potentially toxic fumes, according to various media and eyewitness reports.

Veterans' complaints about nosebleeds, coughing spells, respiratory trouble and debilitating sinus headaches are so prevalent that at least one grassroots advocacy group, Burn Pits 360⁰, has formed. Also, Congress passed a law calling for a VA Airborne Hazards and Open Burn Pit Registry where veterans can document their exposure and report their health problems.

In March, a U.S. Department of Veterans Affairs spokesperson reported there is no information on when the registry will be ready.

"We don't know what the hell we were exposed to," said retired U.S. Army Reserve Master Sgt. Marty Swiss of Franklin (Sussex County). From October 2004 to September 2005, he lived in a Container Housing Unit (CHU) in the Green Zone on the grounds of Saddam Hussein's main palace in Baghdad. "I'm talking piles of garbage 10 or 15 feet in diameter and stockpiled up.

"We lived 100 meters from these things, and there's not much of a wind going over there," he added. "So when this stuff goes up, it's just floating in the air. Flakes of whatever's burning is in the air. We were sucking in this crap for over a year, not even realizing what we were doing. We adjusted to it. We thought, The air stinks and there's not a damn thing we're gonna do about it. We just got on with our jobs."

Today, Swiss, 63, gets sinus headaches so severe, he said, that his head feels as if it's in a vice and someone is turning the screws. If the pain migrates to his stomach, he vomits. But he also feels a pressure in his chest at times and he can't breathe in deeply. Medical testing shows he now has a page-long list of allergies, even to some fruits and vegetables. Before his deployment, he had no allergies.

Last fall Swiss retired from a job as a mechanical engineering tech at Picatinny Arsenal in Rockaway Township. During a yearly test at the arsenal, he said, he had to blow into a hose to test the force of the air he could exhale.

"I couldn't do it," he said. "I could never reach the level I was supposed to reach. I was walking a lot. I try to expand my lung capacity every way I can. Could those pits have had something to do with it? What was in those smoke clouds? How did whatever it was coat the alveoli of my lungs? It scares the daylight out of me to think what I might have taken in, just waiting to get active."

Skills, civilian jobs

While Swiss is retired, younger veterans of the Iraq and Afghanistan wars worry about supporting themselves and their families when they return home to a troubled economy. Though there are programs, services and websites designed to help them, they have reasons for concern. According to a March 2013 Institute of Medicine report, the unemployment rate for post-9/11 veterans 18 through 24 was 30 percent in 2011, compared to 16 percent for non-veterans in the same age group.

U.S. Army Sgt. Matt Cotter of Lake Hiawatha, a combat medic, studied at County College of Morris on the G.I. Bill and graduated in May with an associate of applied science degree in nursing.

"Now I'll take my NCLEX, which is the licensure exam," said Cotter, a 28-year-old father of two. "Then I'll have an RN license and I'll move on to Ramapo College to finish my bachelor's."

That's the good news. The bad news is that most of the medical accreditations he earned in the military — from 2003 through 2011 — are not accepted in the civilian medical field. Neither did his clinical time in the Army count. In the first four years of his service, Cotter flew 1,600 air evacuation missions, picking up seriously wounded soldiers from a number of locations, including Landstuhl Regional Medical Center in Germany, and bringing them safely to Walter Reed Army Medical Center in Bethesda, Maryland.

"In one year, I flew 30 missions for more than 500 soldiers," he said.

Yet he was only able to transfer his CPR license toward his nursing degree.

Feiner, of the VA New Jersey Health Care System, said what happens to medics in the civilian job world is "frustrating for the veterans and for me."

"In the military they perform independent tasks that require a great deal of skill," she said, "but they can't come back and become an EMT (emergency medical technician) or a nurse. They have to go back and do the training here."

On a personal note, adjusting to civilian life takes some doing for a medic, according to Cotter, who says he still stops at roadside wrecks. Once he stopped at a car wreck on a main highway in Washington state as smoke plumed from the vehicle. In the meantime, cars whizzed by.

"I couldn't understand why," Cotter said. "You have to figure there's somebody in the car. There was this poor very young kid, unconscious, in the car, and I pulled him out. God forbid that kid didn't make it. I would feel disgraced. Luckily, he did make it. In fact, I still talk to him.

"For a medic or anybody in the medical field, it's not about glory," he added. "It's about knowing that someone's pulse is still on this planet because of you."

Lingering PTSD

When it comes to women serving in the military, the wars in Iraq and Afghanistan are historic territory. Eleven percent of the veterans from the newest wars who are in the VA New Jersey Health Care System are women, according to Feiner, who added that trend is consistent nationally.

Women in the military are serving in new roles, she added, and even those who don't see combat are still in dangerous situations. They drive vehicles through combat zones subject to fire. They carry guns. They engage the enemy.

With the new roles have come new issues, including military sexual trauma. A total of 31 percent of female veterans of the wars in Iraq and Afghanistan who suffer from PTSD experienced some form of military sexual trauma, according to a study by the George Washington University, in Washington, D.C.

But Einbinder is living proof that life can be difficult for a female Marine even without being abused. Her insomnia and sleepwalking, which started immediately in Iraq, stemmed from her inability to relax and feel safe at any time during her deployment.

She arrived at her base in Al Asad in September 2005. During the observance of Ramadan in October, there were mortar attacks at her base every day, three times a day. Sometimes the shells from an attack would land 100 feet from her.

"You're walking around with your pistol all the time, constantly on edge," Einbinder said. "You just never know where and when you could be attacked. It could happen during the day or in the nighttime."

Or, more to the point, by anyone around her. Einbinder rode a bicycle from her barracks to her squadron most days and worried about coyote attacks. Or attacks by Iraqis on her base who might be pretending to be friendly.

"The Iraqi males don't like the female Americans," Einbinder said, recalling a time she went to get her hair trimmed. "When the guy put the barber cape around me, he tried to choke me. I said, 'It's a little tight.' Then I said, 'I'm not getting my hair cut today. I'll come back.' I just left. It was very scary."

Not that life was easy even in her barracks where Einbinder was the only female officer, there were no lockable doors, and she shared a shower with other Marines.

"I was a little afraid that one of my own might have done something to me," she said. "Nobody did, but there was a fear because there was a couple of times when someone would walk in my room when I was in my pajamas. They'd just plop themselves down while I was lying in my bed. Nobody knew to just get out. I wondered, Are these going to be my brothers protecting me, or men I have to worry about because they've got needs?"

The result for Einbinder was such hypervigilance that she could not sleep. Her flight surgeon recommended Ambien, then an antihistamine to make her drowsy. They didn't work. Her parents sent Nytol sleeping pills from the states. They didn't work, either. Einbinder started sleepwalking at night, sometimes toward dangerous situations.

Today she still sleepwalks and sleepdrives, both involuntarily and subconsciously.

"Once, late at night, I was driving in my pajamas and a cop stopped me," Einbinder said. "Apparently, I was swerving on Oak Ridge Road or Green Pond Road, one of the roads that leads to my parents' house. I told him I was going to work. Then I said I was going to my parents' house. I changed my story because I was asleep.

"Thank God he was sympathetic," she added. "He asked, 'Where are you coming from?' I told him I was coming from work. He asked, 'Would you normally be wearing your pajamas at work?' I said, 'No.' Then I noticed I was wearing my pajamas."

The Institute of Medicine points out that previous wars have shown the needs of veterans don't peak until several decades after they've served, emphasizing that providing care in the moment and planning for the future are paramount.

Irked by attitudes

Even when no particular problem faces veterans, they can be irked by the attitudes of civilians who judge what they did during their service. U.S. Marine Corps Rifleman Nick Guerra, who took part in the historic Battle of An Nasiriyah in Iraq in March 2003, remembers protesters lining the road in North Carolina when he and his fellow Marines were headed home.

"There are a lot of people who are really biased against us. It seems like personal vendettas against us," Guerra said. "War really is hell. It is. Unless you've been there, you can't have an opinion."

Guerra, 32, has coughing spells and nosebleeds now but says he isn't sure of their cause. He experienced his first burn pit at Camp Shoup in Kuwait.

What makes him happy now, he said, are his wife and daughters. He also likes supporting a plethora of organizations that help veterans.

What helps most personally is sharing memories and talking through issues with other Marine veterans, especially those of older generations.

"Semper fi is more than just a word," he said. "When you're in the Marine Corps, you feel like you're on top of the world. You're the best the United States has to offer. But then I look at these guys who were in World War II or Vietnam. I can't compare myself to those guys. I'm humbled whenever I talk to one of them. We look up to them. They're our heroes."

Einbinder, Swiss, Cotter and Guerra all said they would serve again — with pride and love for their country.

"Despite my injuries right now, I would still do it again," Einbinder said. "I love the Marines. I joined because it's in my heart."